2025 Texas sessionsRegular and both called sessions have ended. This index covers House and Senate bills, not resolutions. Statuses come from official reports.

2025 · Regular session · Senate bill

SB855

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Official caption: Relating to the authority of certain medical consenters to assume financial responsibility for certain out-of-network medical care provided to children in foster care.

Signed by governorSource-checked explanation published

Official report lists Senate author(s): Sparks. This does not identify sponsors or amendment drafters.

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Bill explanation published · Version and amendment review scope is stated below · Individual amendment records may not be separately annotated.

Bill highlights

Selected points from the published explanation. Follow each point to its source-linked context; conditions and limits may matter.

SB855 allows an authorized medical decision-maker other than the Department of Family and Protective Services to take financial responsibility for a foster child’s care outside the child’s Medicaid managed-care network.
The person must already be authorized to consent to the child’s medical care under Family Code Section 266.004(b); being a relative or caregiver alone is not enough.
The department is not liable for that care unless a court orders it to cover the cost.
Within 10 business days after the care is provided, the consenter must notify the child’s caseworker in the department’s required form and manner.
Medicaid managed-care organizations may not take adverse action to prevent or discourage access to care under this provision.

Read the full explanation ↓

What does it do?

SB855 allows an authorized medical decision-maker other than the Department of Family and Protective Services to take financial responsibility for a foster child’s care outside the child’s Medicaid managed-care network. It includes behavioral-health care and can include enrolling the child in health insurance. It does not make Medicaid or the managed-care organization pay that outside-network bill. Signed May 21, 2025, it took effect September 1, 2025. Final act; History.

The person must already be authorized to consent to the child’s medical care under Family Code Section 266.004(b); being a relative or caregiver alone is not enough. The outside-network provider must be an individual licensed, certified or otherwise authorized to provide health care in Texas and outside the provider network of the child’s Medicaid managed-care plan. Pharmacies are excluded from this new provider definition. The law permits assuming the cost; it does not require every foster parent or other consenter to do so. Section 266.0043(a)–(b); Existing consent authority.

The department is not liable for that care unless a court orders it to cover the cost. Existing Medicaid access, including in-network benefits, must not be limited. The law also preserves parents’ rights while their children are in the department’s temporary managing conservatorship and preserves courts’ authority to order department payment for outside-network services. Section 266.0043(c)–(d).

Within 10 business days after the care is provided, the consenter must notify the child’s caseworker in the department’s required form and manner. The department must ensure the care records are included in the child’s health passport—the existing electronic health record for foster children. This is a post-care notice requirement, not a new advance-approval step in this section. Section 266.0043(e); Health-passport framework.

Medicaid managed-care organizations may not take adverse action to prevent or discourage access to care under this provision. STAR Health contracts must require compliance, but the prohibition does not itself make the organization financially liable for that care. If a state agency determines federal permission is necessary before implementing a provision, it must request it and may delay that provision until permission is granted. Sections 2–3.

What changed along the way?

All five versions were read and compared. The Senate committee substitute added the pharmacy exclusion, expressly allowed insurance enrollment, preserved parental rights, and added the court-order exception to the department’s nonliability together with an express preservation of court authority. The introduced bill lacked those safeguards and clarifications; its unqualified department-nonliability wording is not the enacted rule.

The Senate committee, engrossed, House committee and enrolled operative texts match. The amendment index lists no floor amendments. The final act retains the introduced bill’s caseworker notice, health-passport recording, managed-care protection and federal-permission provision. Enrolled text.

For the full amendment record, open the official amendment index.

Official bill versions

Compare the published text versions in the official text index. A change is not attributed to a specific amendment here without a verified record.

Who could benefit—and who could bear the costs?

Children may gain another route to a chosen outside-network clinician when an authorized person is willing and able to cover the cost. The person assuming responsibility faces the financial burden; the law does not guarantee reimbursement, coverage under a separate insurance policy or availability of a provider. Keeping Medicaid benefits and recording the outside care can support continuity, but notice and record-sharing add work. Payment, benefits and records provisions.

Both fiscal notes were reviewed. The April 4 Senate-substitute note, matching the final operative text, anticipates no significant state or local fiscal impact. It says contract, policy and procedure changes would be needed and assumes those costs can be absorbed with existing resources. It acknowledges the court-ordered-payment exception; it does not estimate private care costs or guarantee zero public expense in every case.

Official sources

Catalog report retrieved 2026-10-25. Check the official record for corrections or later changes.